Guide for Midwifery Leadership  

Guide for Midwifery Leadership  


Midwives are a vital part of a country’s health system. Midwifery is an evidence-based profession that improves maternal and newborn health outcomes, reduces complications and mortality.  Midwives provide universal care for all childbearing women and newborns.  Midwives also provide care to women with additional needs and complications: assessing, responding and working with other members of the multi-professional team to manage complications and emergencies.   

For an effective midwifery profession and service, midwives need all ten elements of ICM’s Midwifery Professional Framework (2021) to be in place – midwifery philosophy, competencies, education, regulation, associations, midwife-led continuity of care, research, an enabling environment, gender equality and leadership. For more than a decade leadership in midwifery has been a focus of the International Confederation of Midwives (ICM), embedded in its strategic priorities and an acknowledged priority of many national midwifery associations. Strengthening midwifery leadership is a key recommendation in all three ‘State of the World’s Midwifery’ (SoWMy) reports. In the most recent SoWMy, in 2021, investment in midwifery leadership is acknowledged to play a key role in improving the quality and safety of sexual, reproductive, maternal, newborn and adolescent healthcare (SRMNAH) by midwives (UNFPA 2021). 


Developed by ICM Member Associations in the Northern Europe region and approved as a core document by the ICM Council in 2022, this guide sets out what form midwifery leadership should take in every country to support the development of a safe, high quality maternity care system. In this guide, when we describe ‘Midwifery leadership’, we mean the systems, structures, roles and people needed to provide leadership for the midwifery profession and the development of high-quality maternity services in any country.  By ensuring that there are the right midwifery leadership systems, structures, roles and people in the right places, a country will ensure that its maternity services will go from strength to strength, improving the health of childbearing women and their families for generations to come. 

Principles of midwifery leadership  

This guide sets out the recommendation that every country works towards establishing midwifery leaders in six key areas: political strategic leadership, operational, regulatory, education, research and clinical leadership.     

For midwifery leadership to be effective, it must be underpinned by the principles of effective leadership; that is the skills to inspire, influence, advocate, collaborate, communicate, challenge the status-quo, be accountable, and demonstrate compassion (ICM, Professional framework, 2022)  

Strong, effective, compassionate midwifery leadership is founded on investment in and a commitment to growing leaders. The roots of strong and compassionate leadership start in the initial education of midwifery students, and this should continue to be nurtured throughout midwives’ careers. Junior and newly qualified midwives should be supported and encouraged to see themselves as leaders of the profession, understanding that leadership diffuses into all layers and sections of any team. 

Access the Guide for Midwifery Leadership here.

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